36D2112172 CLIA NUMBER - DAYTON GASTROENTEROLOGY, LLC

Laboratory Demographics

  • CLIA Code: 36D2112172
  • Facility Name: DAYTON GASTROENTEROLOGY, LLC
  • Facility Address: 4200 INDIAN RIPPLE ROAD
    BEAVERCREEK, OH
    ZIP 45440
  • Facility Phone: 937 320-5050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA M. STONE
  • NPI Number: 1134345705
  • Taxonomy: 207RG0100X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2112172
LAB Type Physician Office
Facility Name DAYTON GASTROENTEROLOGY, LLC
Street 4200 INDIAN RIPPLE ROAD
City BEAVERCREEK
State OH
ZIP 45440
Phone 937 320-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Physician Office
Lab Director LISA M. STONE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025